Abstracts : Epilepsie

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  • Epileptic amnesic syndrome: 
what is the middle-term evolution ?
    Abstract : B01 – Présenté sous forme de : Communication affichée
    LAMBERT Carole (Strasbourg) - Inter-Région : Grand-Est

    Since the publication of the criteria of the Epileptic Amnesic Syndrome (EAS) in 2006, no additional EAS cohort was published aside from rare case reports. This late-onset syndrome of temporal lobe epilepsy (TLE) thus requires further description. In particular its middle and long-term outcome needs to be addressed: after an improvement of memory performances under anticonvulsants that defines the EAS, less is known about the real cognitive benefit of drug therapy after several years of follow-up.

    We retrospectively studied 25 well-defined EAS patients based on published criteria (followed in Strasbourg-France). All patients underwent standard blood tests, EEG recordings and brain imaging. MMSE and neuropsychological assessments were performed before and after treatment with antiepileptic drugs: first post-treatment evaluation was settled at a mean of 2 years after drug initiation and last evaluation after a mean of 6,2 years. Some patients had additional investigations during the etiological work-up (CSF examination, brain SPECT or PET, FP-CIT scan).

    9 men and 16 women were included, who started seizures at a mean age of 66,2 years. Their electro-radio-clinical features were highly suggestive of late-onset TLE with good seizure response rate (> 90%) to anticonvulsants. Such sensitivity to drug treatment allowed a clear cognitive improvement: MMSE score significantly increased from 26 (± 2,7) to 28,3 (± 1,76) in the first 2 years and maintained at 27.78 (± 2,1) at last visit after a mean of 6,2 years post-treatment. During the same time the neuropsychological profile of tested patients showed significant improvement of memory performances. Based on the MMSE score at last evaluation, we nevertheless distinguished two groups, with different etiological mechanisms. In the “decliners” group (i.e. patients with the lowest MMSE score at last visit), a probable Lewy Body Disease was more frequent (at the dementia or the prodromal stage).

    This study present for the first time the middle-term outcome of the EAS. The overall prognosis of this syndrome appears good with sustained improvement at the whole group level. Nonetheless, in half the cases, our work suggest the probable implication of non-alzheimer neurodegenerative factors that requires close follow-up on a clinical ground.